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Is Chest Pain Related To PCOD,pneumonia And Diverticulitis?

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Posted on Mon, 30 Mar 2015
Question: My sister is in Bayfront Medical Center in Spring Hill, Fl and she is being discharged again without any explanation as to why she is having these symptoms. She went in by ambulance with chest pain and her bp was 154/105. While she was there resting her bp spiked again and a nurse came in and listened to her heart and checked the machine, then shrugged her shoulders saying It beats me why that happened. She was admitted to the tele unit and had an echo and a stress test as well as blood work which all came out ok. She sometimes get unresponsive when this happens to her and it has happened in the past. We have a family history of strokes, cerebral hemorrhage and heart attacks. My son died 2 years ago at 43 from an artery that was blocked 99% without any symptoms. She has been taking b-12 shots and her blood sugar is sometimes perfect and other times she has to start taking b-12 again. She has been in the hospital before for pneumonia, diverticulitis and more than once for chest pain. She was discharged without being told she had an abnormal EKG and did not find out that her EKG said she had a heart attack until her follow up with her PCP, at which time they did another EKG and it was also abnormal. She went to a Cardiologist who did and Echo which also came out normal. She has had kidney problems and was told at one time that she had polycystic kidney disease but now they say that disappeared. Our maternal grandmother had four silent heart attacks and did not know until a chest x-ray showed that when she got pneumonia. Our paternal grandmother had a stroke and our paternal grandfather died of a cerebral hemorrhage when he was 40. We have a first cousin that had to have a kidney transplant at 21 from polycystic kidney disease. My sister has bad teeth and also eczema very bad. At this time she does not have any health insurance nor dental insurance because her husband had been laid off. She in Mass General Hosp in XXXXXXX Ma when she was little and she was covered with red blotches which they biopsied and said she had a rare blood disease, but we have not been able to remember the name of it, nor get the records. The hospital changed her medication to Norvasc and will be discharging her tonight or tomorrow. I hope you can help us because it seems that nobody has been able to and she cannot afford these hopital bills. Thank You
doctor
Answered by Dr. Ajay Panwar (13 hours later)
Brief Answer:
Hypertension with doubtful angina.Please describe unresponsiveness episode.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I have read carefully your sister's complete medical history and what key points I could make out from it are:
Your sister is a case of hypertension with possible angina(may be stable or unstable,as you have not mentioned whether the chest pain occurs on exertion or just at rest).Though, you mentioned about a few episodes of unresponsiveness during chest pain episode,I am doubtful that this unresponsiveness you are referring to is complete loss of consciousness or not?Please tell in details about the unresponsiveness you are talking about.

If ECHO and Stress test have turned normal,then possibility of angina becomes doubtful.

Polycystic ovarian disease,Pneumonia and diverticulitis in the past are unlikely to be related to these recurrent episodes of chest pain.Hypertension is possibly unrelated too.

However,ECHO and Stress test being normal,essentially rules out a major cardiac damage and your sister should be reassured about that.

Management-
1)Continue medicines as taking.
2)Please discuss with your treating physician about putting her on antiplatelets and statins,in view of the EKG changes.
3)A healthy diet and exercise regimen must be ensured.

Lastly,she should be taken into confidence and reassured.

Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ajay Panwar (3 days later)
I was confused and wrote down my vital statistics and not my sister's, she is 50 years old and 5'3" and weighs 118lbs. She has had these symptoms on and off for more than 27yrs. She had an ultrasound done at our church and the tech told her to get checked for Addisons Disease. He said there was 1.4cm cyst on her kidney/and or adrenal gland. This test was done in 2012 and she told her doctor who ruled that out for whatever reason. She has passed out and is nonresponsive, does not hear or see anyone and is asleep with eyes closed and even when she comes to, she cannot respond right away. She has had an inflamed pancreas in the past. Echos and stress test come out negative, urine tests come out too many organisms and has blood in her urine most of the time. Her amylase was 327 and her lipase was 180. Her heart rate was 111 this morning and that is not upon exertion. Her heart rate in the hospital was 105 or more when at rest. I recently read an article on POTS and was wondering if she could have that? She has most of the symptoms only that she is not standing when this happens, it just happens at different times. Please try to figure this out because she cannot get any help in the state of Florida since our Governor has refused federal money to expand the Medicaid program and refuses Medicaid to anyone who does not have children under 18yrs old. She has a multitude of hosptal and associated bills that she cannot afford to pay. Thank you for any insight you can give us on this matter. Sincerely, XXXXXXX XXXX
doctor
Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
MRI Brain/EEG/Autonomic function tests/Serum electrolytes/UTI treatment.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.
If your sister would have presented to me as an outpatient with this medical history,I would have asked to get the following investigations done in order to arrive at a diagnosis:
1)Magnetic resonance imaging(MRI) Brain
2)Electroencephalogram(EEG)-preferably during unresponsiveness or atleast during the period closest possible,to unresponsiveness.
3)Autonomic function tests-Tilt table test,Cardiovagal test
4)Serum electrolytes-serum sodium and potassium

Please follow-up with the results of these tests,so that I can answer your query well,further.
Meanwhile,please get her evaluated for her urinary abnormalities by a urologist and get her treated for the possible Urinary tract infection(UTI).

Inflamed pancreas of the past and renal cyst should not be causing the present symptoms.
Please upload the Ultrasound report which suggested adrenal abnormality.Serum electrolytes may be deranged in adrenal abnormality.So,please follow-up with the electrolytes report.

Waiting for your follow-up with the results of investigations.

Dr.Ajay Panwar,
MD,DM(Neurology)
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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Is Chest Pain Related To PCOD,pneumonia And Diverticulitis?

Brief Answer: Hypertension with doubtful angina.Please describe unresponsiveness episode. Detailed Answer: Hi XXXX, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. I have read carefully your sister's complete medical history and what key points I could make out from it are: Your sister is a case of hypertension with possible angina(may be stable or unstable,as you have not mentioned whether the chest pain occurs on exertion or just at rest).Though, you mentioned about a few episodes of unresponsiveness during chest pain episode,I am doubtful that this unresponsiveness you are referring to is complete loss of consciousness or not?Please tell in details about the unresponsiveness you are talking about. If ECHO and Stress test have turned normal,then possibility of angina becomes doubtful. Polycystic ovarian disease,Pneumonia and diverticulitis in the past are unlikely to be related to these recurrent episodes of chest pain.Hypertension is possibly unrelated too. However,ECHO and Stress test being normal,essentially rules out a major cardiac damage and your sister should be reassured about that. Management- 1)Continue medicines as taking. 2)Please discuss with your treating physician about putting her on antiplatelets and statins,in view of the EKG changes. 3)A healthy diet and exercise regimen must be ensured. Lastly,she should be taken into confidence and reassured. Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review. Dr.Ajay Panwar, MD,DM(Neurology)